Carbohydrate composition for flat glucose response

ABSTRACT

A low-glycemic available carbohydrate composition of the invention contains the following components:
     (i) 5-60 wt. % of one or more monosaccharides selected from monosaccharides other than glucose and fructose, in particular galactose, ribose and mannose;   (ii) 15-95 wt. % of oligosaccharides having a length of 2 to 20 anhydromonose units, at least half of which are anhydroglucose units linked by non-α-1,4 bonds; these oligosaccharides preferably comprising disaccharides such as palatinose, isomaltose and trehalose and/or non-α-1,4 linked higher glucose-containing oligosaccharides;   (iii) 0-45 wt. % of other available carbohydrates, such as glucose and maltodextrins.
 
This carbohydrate composition can be part of a food composition for the treatment of diabetes, obesitas, insulin resistance, or for postprandial glucose response.

FIELD OF THE INVENTION

The invention relates to a carbohydrate fraction that gives a sustainedand lower glucose release after consumption.

BACKGROUND OF THE INVENTION

Glucose is an important source of energy to the cells in the human bodyand is abundantly present in food ingredients. After consumption ofstarch or other dietetic available sources of glucose and theirsubsequent digestion, glucose is released in the gastro-intestinaltract, where it is rapidly and effectively absorbed from the intestinallumen. This will usually increase glucose concentrations in blood. Thechange in glucose after consumption of a food is called the postprandialglucose response (PPGR), which can be measured as the area under thecurve (AUC), which plots the plasma glucose concentration with time. Thehuman body strives to maintain homeostasis of glucose levels in tissueand blood with time, in order to allow proper functioning of all cells.One important instrument to achieve glucose homeostasis is the releaseof insulin by the pancreas when the concentration of specific foodcomponents like glucose starts to increase. Under normal circumstancesthis will increase glucose transport into the cell and the formation ofglycogen using glucose, and trigger other metabolic changes, therewithrapidly causing the blood glucose levels to decrease to normal levels.

A person that does not react properly on released insulin is said to beinsulin-resistant. Large groups of persons suffer from insulinresistance like many obese persons, persons suffering from the so calledmetabolic syndrome (or syndrome X), diabetics and many patients inhospitals or nursing homes who developed a temporarily or longer lastinginsulin resistance as a cause of their disease. Part of the diabeticsalso experience an insufficient capacity to increase insulinconcentrations in blood after consumption of food (calledpost-prandially). Persons that suffer from insulin-resistancedemonstrate abnormal high postprandial glucose response, even afterconsumption of moderate amounts of food ingredients that compriseglucose. When high postprandial glucose concentrations occur relativelyfrequently and over longer periods of time, they can cause severalsevere health problems. Known secondary side effects, as can be found indiabetics, are problems in the cardio-vascular system, such ashypertension, atherosclerosis, bad blood supply to peripheral tissues,stroke, heart attacks etc., as well as problems in the kidney, inparticular an abnormal glomerular filtration rate, and a wide range ofneuropathies and retinopathies like cataract. It was also found thatmortality of severe disease in hospital patients is associated with theseverity of insulin resistance.

The decrease of postprandial glucose response (PPGR) has been thesubject of numerous research efforts. Many types of carbohydrates havebeen proposed to induce a low PPGR. Also inclusion of dietetic fibre inparental a nutritional product has been proposed for this purpose, forexample viscous fibres, like gums or pectin. The disadvantage of usingsuch fibres is the increase in viscosity, leading to bloating,flatulence, loss of appetite and possibly constipation, when used inliquid products in amounts that are effective.

DE 3935906 discloses the use of galactose for the nutrition ofmetabolically stressed patients, e.g. suffering from diabetes mellitus.Other saccharides such as glucose, mannose, N-acetylglucosamine,N-acetylgalactosamine, fucose, fructose or lactulose may also bepresent, although it is preferred that galactose represents at least 50%or even at least 75% of the saccharides. Amino acids, salts etc. arealso included in the parenteral administration.

WO03/104473 discloses the galactosylation of hydrogenated andnon-hydrogenated isomaltulose to produce oligosaccharides that areuseful as probiotics. They are also to be useful for modulating glycemicproperties of food products.

WO04/081022 describes a grain composition containing prebioticisomalto-oligosaccharides obtained by transglucosylation of maltose. Thecomposition can be used for various purposes, including a bakingingredient and an oral rehydration solution.

EP-A 1229803 by Stahl also discloses specific synthetic oligosaccharidesobtained by trans-glucosylation, that are slowly digestible.

WO 01/17370 discloses the use of trehalose for providing nutrition topersons suffering from disorders of insulin metabolism. The trehalosereplaces other sugars, such as sucrose, glucose and maltose, whichshould be substantially absent.

It is an object of the invention to provide a nutritional product thatis effective in rapidly providing glucose to the consumer andmaintaining a clinically significant supply of glucose during aprolonged time without resulting in undesirably high concentrations ofglucose in the blood, even in persons that have becomeinsulin-resistant.

It is a further object of the invention to a provide nutritional productfor persons that suffer from insulin resistance, in order to preventdevelopment of disorders which result from prolonged and frequent highlevels of glucose in blood, such as those diseases that result fromadvanced glycation products (AGE), neuropathies, retina problems, andkidney problems.

DESCRIPTION OF THE INVENTION

It was found that the combination of one or more of monosaccharidesother than glucose and fructose, especially one or more of galactose,mannose and ribose, with glucose-containing oligosaccharides in whichthe glucose is at least partly linked by non-α-1,4 bonds is suitable asa low glycemic composition which provides glucose to the human body in aslow released and sustained way, wherein the monosaccharides contributeto the glucose availability through metabolic conversion. Not only doesthis combination have a positive effect on the glycemic and insulinaemicresponse (GI) or the total area under the PPGR curve, but it alsoestablishes a substantially flat PPGR over longer periods. A desirablePPGR is found to be one that shows a rapid but limited initial increaseof the concentration of glucose in blood after administration, in orderto give a quick improvement of energy status and prevent too low levelsof glucose for proper functioning, and then stabilises for a longerperiod. This is particularly important for persons suffering fromhypoglycemic levels, which are defined to be fasting glucose levelsbelow 3.0 mM.

The low glycemic alpha-gluco-oligosaccharides are characterised ashaving a GI lower than 60, whereas the abovementioned non-glucosemonosaccharides function as an insulin-releasing agent to stimulate theuptake of the blood glucose, and moreover, to decrease the amount ofmetabolic stress to the liver. The prolonged increase of plasma glucoselevels is especially important for persons that cannot eat at regularintervals and for example as night time formula for infants.

Thus, the invention pertains to a low-glycemic available carbohydratecomposition containing a combination of (i) 5-60 wt. % of one or moremonosaccharides other than glucose and fructose and (ii) 10-75 wt. % ofglucose-containing oligosaccharides having a length of 2 to 20anhydromonose units, containing at least one non-α-1,4-linked (i.e.non-maltose-type) anhydroglucose unit. It was found that the combinationof the monosaccharides, which are insulinotrophic, i.e. stimulateinsulin release without substantially increasing blood glucose levels,and the oligosaccharides which also give a low post-prandial glucoseresponse, results in an sustained energy supply with an essential flatglucose response.

As used herein, the term ‘low glycemic’ means having a glycemic index(GI) below 60, preferably below 50; the GI being commonly understood asbeing the relative rate of production of blood glucose compared toglucose (having a GI of 100 by definition). The term ‘availablecarbohydrate’ is understood to mean a carbohydrate capable of beingdigested by the enzymes in the gastrointestinal tract. The digestionproducts or the carbohydrates themselves are absorbed in the first partof the intestine, in particular by the small intestine. Under normalconditions these compounds or their digestion products do not reach thecolon. Available carbohydrates can also be defined according to theAmerican Association of Cereal Chemists (AACC) as capable of beingabsorbed as monosaccharides and metabolised by the (human) body. Foodregulations typically oblige manufacturers to mention on the label of anutritional product inclusion thereof as digestible carbohydrates andthey are defined to contribute 4 kcal per g material to the energycontent of the product.

The term ‘monosaccharides other than glucose and fructose’ as usedherein comprises any monosaccharide, being an aldose or ketose, or beinga pentose or hexose. Examples include ribose, xylose, arabinose,ribulose, galactose, gulose, idose, mannose, sorbose and tagatose.Preferred monosaccharides are ribose, galactose and mannose, and mostpreferred is galactose. It is preferred that galactose represents atleast 25% of the monosaccharides other than glucose and fructose in thecomposition of the invention. The proportion of such monosaccharidesother than glucose and fructose, especially galactose, ribose and/ormannose, in the composition of the invention is preferably 5-45 wt. %,more preferably 8-40 wt. %, most preferably 10-30 wt. % of the availablecarbohydrates.

Glucose-containing oligosaccharides comprise any and all oligosaccharidehaving a chain length of 2 up to 20 anhydromonose units containing atleast one anhydroglucose unit in any position. The term ‘anhydro’ isgenerally used to denote sugar units which are a member of a chain,regardless of their position in the chain and including terminal units.It is preferred that at least half of the anhydromonose units of theoligosaccharides of the carbohydrate composition of the invention areanhydroglucose units. More preferably, the oligosaccharides have amajority of anhydroglucose units, most preferably they contain no morethan one anhydromonose unit other than anhydroglucose.

The terms ‘anhydroglucose unit linked by non-α-1,4 bonds’ or‘non-maltose-linked anhydroglucose unit’ are used to denote ananhydroglucose unit (AGU) which is not a terminal or internalα-1,4-linked AGU's. Such an AGU is linked at its anomeric α-position toanother anhydromonose unit at another position than the 4-position of aglucose unit or the 2-position of a fructose unit. In particular, suchan AGU is linked at its α1-position to the 1-, 3-, 5- or 6-position ofanother anhydromonose unit or also to the 2-position of anotheranhydroglucose unit. As a less preferred alternative, or in addition, itmay be linked at its 2-, 3- or 6-position with any position of anotheranhydromonose unit. For example, AGU's may be linked by α-1,1, α-1,2,α-1,3 and α-1,6 bonds. Hence, maltose, sucrose and lactose are notincluded in these oligosaccharides. One or more α-1,4 linked AGU may bepresent, as long as differently bound AGU's are also present at least atthe same occurrence. Preferably, no more than 1 AGU is linked by anα-1,4 bond.

Examples of such oligosaccharides include the glucosyl-glucosedisaccharides isomaltose (α-1,6), nigerose (α-1,3), kojibiose (α-1,2),trehalose (α,α-1,1), gentiobiose (β-1,6), laminaribiose (β-1,3) andsophorose (β-1,2), the hetero-disaccharides primeverose, allolactose,trehalulose, turanose, maltulose, leucrose, isomaltulose (=palatinose),the trisaccharides isomaltotriose, panose, kojitriose, and the like, andthe higher homologues up to the decasaccharides, such asisomaltodecaose, and even the icosasaccharides. The disaccharides andtrisaccharides are preferred, most preferred are trehalose, trehalulose,palatinose, isomaltose and panose. The glucose-containingoligosaccharides can be obtained from natural sources or synthesised byenzymatic isomerisation of saccharides such as sucrose, and several ofthem are commercially available. The oligosaccharides can also beobtained by enzymatic transglucosylation of e.g. maltose to producemainly α-1,6-linked oligoglucoses (isomalto-oligosaccharides). Theoligosaccharides may be have a straight chain or may be slightlybranched. Further examples include oligonigerose, and alternan-typeoligosaccharides.

Not comprised in the available glucose component ii) are so-calledresistant malto-dextrins, commercially available as e.g. Fibersol-2 andNutriose. These have a predominant fibre character, and may partlycontain β-linkages. These fibre-type oligosaccharides can be assessed byhydrolysis activity of rat intestinal powder as described by Mishima etal., J. Agric. Food Chem. 2005, 53, 7257-7261. Saccharides that are nothydrolysed in this intestinal rat test are considered as not beingavailable.

The preferred proportions of oligosaccharides (ii) in the composition ofthe invention is 15-75 wt. %, more preferred 18-50 wt. %, of whichpreferably 10-60 wt. %, more preferably 15-45 wt. %—based on theavailable carbohydrate composition—consists of disaccharides (ii-a) suchas trehalose, trehalulose, palatinose, turanose, leucrose andisomaltose. Among these, the fructose-containing disaccharides,trehalulose, palatinose, turanose and leucrose, and especiallypalatinose, are of particular interest. Breakdown of palatinose forinstance only takes place in the intestines, involving the use ofisomaltase.

Preferably, the components (i) and (ii) as defined above togetherconstitute 25-100, preferably 28-75, most preferably 32-60 wt. % of theavailable carbohydrate composition, and hence the amount of otheravailable carbohydrates (iii) is 0-75, preferably 25-72, most preferably40-68 wt. %. In an alternative embodiment, the carbohydrate compositionaccording to the invention may contain (iii) 0-45 wt. %, preferably10-40 wt. % of other available carbohydrates.

Taking into account only components (i) and (ii), which are present inthe compositions of the invention in relative proportions of 5-60 and10-75 weight parts, their proportions on a 100% basis are (i) 5/80-60/70and (ii) 10/70-75/80, or (i) 6.25-85.7 wt. % and (ii) 14.3-93.75%. Themost preferred ratios are (i) 10/60-30/48 (16.7-62.5 wt. % and (ii)18/48-50/60 (37.5-83.3 wt.). Taking only the disaccharides (ii-a), therelative proportion is (i) 5/65-60/70 (7.7-85.7 wt. %) and (ii-a)10/70-60/65 (14.3-92.3 wt. %), most preferably (i) 10/55-30/45(18.2-66.7 wt. %), and (ii-a) 15/45-45/55 (33.3-81.8 wt. %). Theseratios apply in particular to the combination of galactose andpalatinose. Combinations of these specific monosaccharides and specificdisaccharides, for instance galactose and palatinose, exhibit synergismin providing a quick and sustained glucose response.

These other available carbohydrate may first of all comprise (iii-a)available glucose sources, in the form of monomeric glucose or readilyavailable glucose oligomers and polymers such as maltose, maltodextrins,and non-resistant starch; such glucose source contains anhydroglucoseunits exclusively or predominantly (>90%) bound through α-1,4 linkages.The availability of glucose from these sources can be determined by themethod of Englyst et al. (Am. J. Clin. Nutr. 1999, 69, 448-454): theproportion of glucose source from which glucose becomes available within120 minutes from the start of the test is accounted to component (iii)of the composition of the invention. The proportion that does not passthis test is denoted as ‘fibre’ for the purpose of the invention, and isnot accounted for within the present 100% of the available carbohydratecomposition as defined herein. Within the available carbohydrates, theproportion of glucose source from which glucose becomes available within20 minutes from the start of the test is counted as rapidly availableglucose sources, according to the Englyst method.

These available glucose sources may be present at such a level that thetotal glycemic index of the product remains below 75, preferably below60, especially below 50.

Furthermore, component (iii) may comprise (iii-b) other mono- anddi-saccharides. For example, fructose may be present at a level of e.g.4-25 wt. %, especially 6-18 wt. %, lactose may be present at e.g. from 0up to about 15 wt. % preferably 1-10 wt. %, sucrose from 0 up to 5 wt.%. The aforementioned amounts of galactose and fructose according to theinvention do not comprise the galactose-part of lactose and thefructose-part of sucrose and palatinose when used.

It is preferred that the amount of rapidly available glucose is 1.25-10,more preferably 1.5-6 times the weight amount of free galactose, whengalactose is included in the formula. When free ribose is included, theweight amount of rapidly available glucose, in particular of freeglucose is 0.8-10 and preferably 1-8 times as high as the amount of freeribose. When free fructose is included, the ratio of the weight ofrapidly available glucose to that of fructose is preferably be in therange 1:0-0.12.

It is noted, that for the purpose of defining the composition of theinvention, oligosaccharides that are not covered by components (ii) and(iii) are considered not to be available carbohydrates; the same appliesto polysaccharides that do not fall under component (iii).

Furthermore, polyols, such as mannitol, lactitol, isomaltitol (isomalt,6-O-alpha-D-glucopyranosyl-D-sorbitol) etc. are not covered by thecomponents (i), (ii) and (iii), which account for 100% of the availablecarbohydrate composition. However, such polyols may be present, e.g. ata level of 0-20 wt. % of the available carbohydrate composition.

The available carbohydrate composition may be used as such, e.g. as asupplement, or be part of a partial or complete food product, furthercontaining proteins and/or lipids and/or fibres, minerals, vitamins etc.The composition may be a dry powder, or a solid or semi-solidcomposition. Preferably, the food product is a liquid, suitable for tubeor sip feeding. It has an osmolality of preferably 300-700, morepreferably 330-600, most preferably 340-500 mOsm/l, and having an energydensity between 0.6 and 2.0, more preferably between 0.75 and 1.5kcal/ml. In a liquid, the product preferably comprises the availablecarbohydrate fraction of the invention in an amount of 60-200,preferably 80-160, more preferably 100-140 g/l.

It is advantageous to include non-viscous fibres in the product. Viscousfibres, optionally in combination with other food components, are knownto influence gastric emptying rates, and the rate of digestion of foodsin the gastrointestinal tract. It is now found that the fibres thatpreferably are included in the product according the invention shouldnot behave as viscous fibres, neither in the product nor in thegastrointestinal tract. The fibres that can be used according to theinvention are advantageously selected in such a way and included in suchconcentrations that they exhibit a low viscosity in a nutritionalcomposition. Such fibres appear to exhibit a low viscosity also under invivo conditions. Fibres that can suitably be used are transgalacto-oligosaccharides (GOS), and extensively hydrolysed gums,hydrolysed mannans, hydrolysed arabans, hydrolysed xylans, hydrolysedbeta-glucans, hydrolysed fructans (fructose-oligosaccharides, FOS),inulin and/or oligofructoses. Also, so-called resistant (non-digestible)maltodextrin fibres may be used. Such non-viscous, typically solublefibres are preferably used in an amount of 0-30 wt. %, preferably 4-24wt. % of the available carbohydrate composition, and thus countingoutside the 100% thereof. On energy basis, these fibres can be used at alevel of e.g. 0-5 g, especially 0.4-4, in particular 0.6-3 g per 100kcal, and on a liquid basis, 0-40, preferably 2-30, more preferably 4-25g/l.

In addition to these non-viscous, soluble fibres, poorly soluble orinsoluble fibres such as resistant starch, cellulose and the like may bepresent, e.g. at a level of 0-30 wt. %, preferably 4-20 wt. % of theavailable carbohydrate composition, or 0-4, especially 0.3-3 g per 100kcal, or 0-30, preferably 2-20 g/l.

The total amount of non-starch and resistant starch fibres is preferablyin the range of 2-50, preferably 4-40, more preferably 6-30 g/l. Theviscosity of the product is low in order to provide acceptable flowingcharacteristics for sip-drinking and for tube feeding. Measured at 20°C. at a shear rate of 100/sec, viscosity is 1-60, preferably 1.4-40,more preferably 1.8-30 Mpa.s (for reference: the value for water isone).

The nutritional products of the invention may further comprise aninsulin-releasing agent, preferably sulfonylurea, and/or an antidiabeticdrug, preferably biguanidine and/or thiazolidinedione. If sulfonylureais present, the composition of the invention preferably contains anamount of 0.1-4 g per kg hereof.

The nutritional compositions of the invention may comprise a proteinfraction. Such a protein fraction can be based on a source of vegetableprotein, to which at least one free amino acid, a peptide or a proteinfrom animal source can be added. The protein fraction preferablyoriginates for 15-99.9 wt %, preferably 20-95 wt % from plant speciesbelonging to the species of fabales or leguminosae. It is preferred thatthe proteins originate from one or more members of the group of soybean(Glycine max), pea (Pisum species), bean (Phaseolus species), fenugreek(Trigonella species), lupin, lentil (Lens species), peanut (Arachisspecies), tamarind, clover and alfalfa. Such protein compositionsfurther support the improvement of postprandial glucose response andpostprandial insulin response. The amino acids or peptides are selectedto be rich in those amino acids which increase nutritional value of theprotein fraction as a whole in terms of the demand for essential aminoacids. In particular these amino acids are lysine, leucine andphenylalanine. The compositions may comprise per 100 g amino acids 1.8-5g methionine, and/or 4.5-9 g threonine, and/or 8.6-17 g leucine, and/or5.5-9.5 g proline. The protein source of animal origin is selected inparticular from milk proteins and liquefied proteins from muscle fromanimal or fish-like hydrolysed proteins. Milk proteins are particularlypreferred, especially whey proteins and more in particular those wheyproteins that comprise less than 40 wt % and preferably less than 30 wt.% kappa-casein or glycomacropeptide, calculated on protein base.

The amount of protein in the products is preferably 0.5-15 g, morepreferably 1-10 and most preferably 2-7 g per 100 ml product. Calculatedas the amount of energy that is provided by proteins, lipids anddigestible carbohydrates, by using the Atwater factors (4, 9, 4,respectively) for each of them, the amount of energy for protein is10-30, preferably 14-28, most preferably 17-26 en %, and for digestiblecarbohydrates 35-70, preferably 40-60 and most preferably 42-55 en %.The composition comprises 5-80, preferably 20-50 g/l of a proteinfraction.

The nutritional compositions of the invention can further comprise a fator lipid fraction. Such a lipid fraction comprises oleic acid andessential fatty acids like linoleic acid and alpha-linolenic acid, butcould also comprise conjugated linolenic acids and omega-3 long chainfatty acids like eicosapentaenoic acid and docosahexaenoic acid. Thefatty acids preferably comprise less than 10 wt % saturated fatty acids,and less than 1 wt % of trans fatty acids. The amount of lipid is 10-60,preferably 15-50, more preferably 31-46 g/l. Expressing the amount oflipid in the product as en % using the Atwater factors the amount oflipid is 25-45, preferably 28-40 and most preferably 30-38 en %. Lipidsinclude triglycerides, diglycerides, monoglycerides,(lyso)phospholipids, sphingolipids and ceramides. Other components thatare soluble in petroleum ether or hexane, like cholesterol and othersterols, are not included in calculations about the lipid fraction.

Moreover the product can comprise micro-ingredients like vitamins, traceelements and minerals that are known in the art and carnitineequivalents, inositol, taurine and other food constituents such asflavours, colorants or manufacturing aids. The amount of calcium andphosphorous are also selected to be within the range of 10-70,preferably 20-60 mg/100 ml. The ratio of calcium to phosphorous is inthe range 0.8-2, preferably 1.1-1.9, more preferably 1.3-1.8.

The available carbohydrate composition and nutritional compositionaccording to the invention are useful in maintaining a low and prolongedglucose response in blood and tissue after consumption, and especiallyuseful in cases of diabetics and/or insulin-resistance. People thatsuffer from or are extremely susceptible to insulin-resistance are e.g.severely or critically ill patients, in particular palliative patientslike those that suffer from severe cancer or HIV infection. Other groupsof patients suffering from difficulties to control their PPGR comprisethose persons that were subjected to major surgery or exposed to othertraumata, malnourished persons in particular those suffering fromprotein-energy malnutrition, persons that suffer from obesity, theMetabolic Syndrome, Syndrome X, hyperglycaemia, hyperinsulinaemia,dyslipidaemia, hypertriglyceridaemia and dysfibrinolysis, but also largeparts of the group of the elderly in Western societies. In addition theproduct can be useful for persons that have an increased risk in termsof a hereditary history of developing insulin resistance, PPGR in themammal's blood for a period starting after 20 minutes to 4 hours afteradministration. It is even more preferred to maintain the glucoseconcentration stable until 3 hours, more preferably until 2 hours afteradministration. A substantially flat glucose level or PPGR means thatthe glucose level in blood does not vary more than about 1.6 mM andpreferably less than 1.3, more preferably less than 1.0 mM per 20minutes during the above-mentioned period after consumption.

In case of diabetics, the glucose blood levels are typically maintainedbetween 4 mM and 15 mM. However, in the case of severe diabetics, peakpostprandial glucose concentrations above 15 mM can still be observed.Under these circumstances the nutritional composition comprising thecarbohydrate fraction of the invention should be consumed in more thanone eating session and/or in combination with administration of anappropriate amount of insulin prior to consumption of the food product.In case of non-diabetics it is possible to control the glucose bloodlevel even below 11 mM.

Preferably the glucose levels in plasma can be controlled between 5 and8 mM in the abovementioned period, without the necessity to consumelarge amounts of fibre with it, as this may cause gastrointestinaldiscomfort, and without replacing glucose sources by othercarbohydrates, which demand an unrealistic high metabolic capacity inthe person, or by high amounts of lipids, which may disturb obesity ordiabetics like many Hindustan persons and several Caucasian families,for persons that plan irregular feeding pattern, like sportsmen duringan enduring exercise or persons that desire to maintain attention forlonger periods of time, like students during studying or examines orduring meetings.

Thus, the available carbohydrate compositions and nutritionalcompositions of the invention can be used for the prevention and/ortreatment of diabetics, insulin-resistance, obesity, controllingpostprandial glucose response, metabolic syndrome, syndrome X,hyperglycaemia, hyperinsulinaemia, dyslipidaemia, hypertriglyceridaemia,dysfibrinolysis and/or disorders associated with major surgery or traumain a mammal, by maintaining a substantially stable glucose level orphysiologically acceptable blood lipid or cholesterol profiles.

Moreover the products are effective in decreasing the risk for obtainingand decreasing the aggravation of several diseases which are associatedwith frequently elevated blood glucose levels, which includeretinopathies, kidney diseases and neuropathies. Also diseasesassociated with the occurrence of advanced glycation products (AGE) canbe prevented. Effectiveness of the product can be determined bymeasuring the levels of glycated haemoglobin molecules (Hb1Ac) in blood.

EXAMPLE 1

Two liquid formulas A and B for diabetes patients were preparedcontaining the following ingredients per 100 ml:

A B Total protein 4.75 (19 en %) 4.75 (19 en %) Total lipids 3.78 (34 en%) 3.78 (34 en %) Total available carbohydrates 11.15 (47 en %)  11.75(47 en %)  Galactose 1.5 1.75 Ribose 0.3 — Palatinose 3.0 2.0Isomaltitol 0.6 — Isomalto-oligosaccharides — 2.75 Glucose 1.5 1.7Maltodextrins 3.0 2.2 Non-resistant starch # 1.0 0.9 Lactose * 0.6 0.25Fructose 0.15 0.2 Total fibres 2.0 2.0 Galacto-oligosaccharides (GOS)0.9 — Hydrolysed guar — 1.0 Cellulose 0.1 0.1 Resistant starch ## 1.00.9 Vitamins, minerals, water + + # The digestible (available) part of acommercial resistant starch ingredient ## The non-digestible part of acommercial resistant starch ingredient * Including the lactose of theGOS ingredient

EXAMPLE 2

Liquid compositions C and D (sipfeed or tubefeed) for diabetes patientswere prepared containing the following ingredients per 100 ml:

Energy: 419 kJ (100 kcal) Protein fraction: 19.4 en % 4.86 gα-Lactalbumin-enriched whey protein 2.43 g Soy protein 2.43 g Lipidfraction: 34.2 en % 3.80 g rapeseed/sunflower (Canola HO blend 331) 3.17g sunflower oil HOA (Trisun 347) 0.20 g low-erucic rapeseed oil (Canola338) 0.20 g marinol 0.10 g other 0.13 g Digestible carbohydratefraction: (see below) 46.4 en % 11.63 g  Fibre: 2.00 ggalacto-oligosaccharides 1.00 g cellulose 0.10 g Nutrilose FM06(non-digestible part) 0.65 g resistant starch (non-digestible part) 0.25g Minerals: (in mg) Na (37.5), K (100), Cl (37.5), Ca (47.0), P (37.5),Mg (23.0) Trace elements: (in μg) Fe (1600), Zn (1400), Cu (210), Mn(330), F (100), Mo (10.0), Se (7.5), Cr (12.0), I (13.0) Vitamins: (inμg) vit. A (82 RE), carotenoids (200), vit. D (1.2), vit. E (2500 α-TE),vit. K (5.3),vit. B1 (400), vit. B2 (200), niacin (1800 NE), pantothenicacid (800), vit. B6 (300), folic acid (38), vit. B12 (0.65), biotin(6.5), vit. C (15.0), choline (37).Compositions C and D differ in the digestible carbohydrate fraction, asfollows:

C D Total available carbohydrates 11.63 11.63 Galactose 1.50 1.50Fructose 1.50 — Palatinose 2.40 4.40 Alternan, DP 10 2.00 — Glucose 1.501.50 Cleargum (tapioca starch) 0.80 2.80 Digestible part of resistantstarch product 0.25 0.25 Digestible part of Nutriose FM06 0.12 0.12Other * 1.56 1.06 * Including the lactose of the GOS ingredient

The invention claimed is:
 1. A low-glycemic carbohydrate compositioncomprising the following components: (i) 5-60 wt. % of one or moremonosaccharides, wherein the monosaccharides are not glucose orfructose; (ii) 10-75 wt. % of oligosaccharides having a length of 2 to20 anhydromonose units, wherein the oligosaccharides are selected fromthe group consisting of trehalose, trehalulose, palatinose, isomaltose,turanose and leucrose; (iii) 0-75 wt. % of other availablecarbohydrates.
 2. The carbohydrate composition according to claim 1,wherein components (i) and (ii) constitute 28-75 wt. % of thecomposition.
 3. The carbohydrate composition according to claim 2,wherein components (i) and (ii) constitute 32-60 wt. % of thecomposition.
 4. The carbohydrate composition according to claim 1 or 2,comprising: (i) 8-40 wt. % of one or more monosaccharides selected fromgalactose, ribose and mannose.
 5. The carbohydrate composition accordingto claim 1, wherein the monosaccharides of component (i) are selectedfrom the group consisting of ribose, xylose, arabinose, ribulose,galactose, gulose, idose, mannose, sorbose and tagatose.
 6. Thecarbohydrate composition according to claim 1, comprising: (ii) 10-50wt. % of the oligosaccharides.
 7. The carbohydrate composition accordingto claim 6, wherein the oligosaccharides are selected from the groupconsisting of trehalose, trehalulose, palatinose and isomaltose.
 8. Thecarbohydrate composition according to claim 6, comprising: (ii) 18-45wt. % of the oligosaccharides.
 9. The carbohydrate composition accordingto claim 1, further comprising 2-30 wt. %, based on the total dry weightof components i)-iii) in the composition, of nutritional fibres.
 10. Thecarbohydrate composition according to claim 1, comprising (i) 5-60 wt. %of galactose and (ii) 10-60 wt. % of palatinose.
 11. The carbohydratecomposition according to claim 10, comprising (i) 10-30 wt. % ofgalactose and (ii) 15-45 wt. % of palatinose.
 12. The carbohydratecomposition according to claim 1, wherein the monosaccharides comprisegalactose, ribose, mannose, or a combination thereof.
 13. Thecarbohydrate composition according to claim 1, comprising: (i) 8-40 wt.% of one or more monosaccharides selected from galactose, ribose andmannose.
 14. The carbohydrate composition according to claim 13,comprising: (i) 10-30 wt. % of one or more monosaccharides selected fromgalactose, ribose and mannose.
 15. The carbohydrate compositionaccording to claim 13, comprising: (i) 8-40 wt. % of galactose.
 16. Thecarbohydrate composition according to claim 1, comprising: (ii) 10-60wt. % of oligosaccharides selected from the group consisting oftrehalose, palatinose, turanose and leucrose.
 17. A method for thetreatment of diabetes, obesity, insulin resistance, or for postprandialglucose response in a patient, comprising administering to the patientthe carbohydrate composition according to claim
 1. 18. A liquidnutritional composition comprising: (i) 5-60 wt. % of one or moremonosaccharides, wherein the monosaccharides are not glucose orfructose; (ii) 10-75 wt. % of oligosaccharides having a length of 2 to20 anhydromonose units, wherein the oligosaccharides are selected fromthe group consisting of trehalose, trehalulose, palatinose, isomaltose,turanose and leucrose; (iii) 0-75 wt. % of other availablecarbohydrates; and (iv) lipids and/or proteins, the availablecarbohydrates accounting for 35-70 en % of the nutritional composition.